التهاب المعدة الضموري التحولي المناعي الذاتي: العلاج الإنقاذي عند فشل استئصال H. pylori في المرحلة الأولى

References

DOI: 10.14309/ajg.0000000000002968

• Given the implications of potentially undiagnosed H. pylori infection for cancer risk and exacerbating nutritional deficiencies (e.g., iron deficiency), H. pylori testing and treatment in all patients diagnosed with AIG are recommended.
• Of the recommended and suggested options for treatment-naive patients, only optimized BQT is suitable for patients with a true penicillin allergy.
• In treatment-experienced patients with persistent H. pylori infection who have not previously received BQT, optimized BQT is suggested (conditional recommendation; very low quality of evidence).
• In treatment-experienced patients with persistent H. pylori infection who have received BQT, rifabutin triple therapy is suggested (conditional recommendation; low quality of evidence).
• In treatment-experienced patients with persistent H. pylori infection, there is insufficient evidence from North America to recommend high-dose PPI or PCAB dual therapy (no recommendation; evidence gap).
• All patients who are treated for H. pylori infection should undergo a test of cure with an appropriately conducted urea breath test, fecal antigen test, or biopsy-based test at least 4 weeks after completion of therapy.